| Casey Ferguson Lpc Inc | |
|
6580 Valley Center Dr Ste 169 Radford VA 24141-5694 | |
| (540) 505-2986 | |
| (540) 380-0079 |
| Full Name | Casey Ferguson Lpc Inc |
|---|---|
| Speciality | Counselor |
| Location | 6580 Valley Center Dr Ste 169, Radford, Virginia |
| Authorized Official Name and Position | Casey Elizabeth Ferguson (OWNER) |
| Authorized Official Contact | 5405052986 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Casey Ferguson Lpc Inc 6580 Valley Center Dr Ste 169 Radford VA 24141-5694 Ph: (540) 505-2986 | Casey Ferguson Lpc Inc 6580 Valley Center Dr Ste 169 Radford VA 24141-5694 Ph: (540) 505-2986 |
| NPI Number | 1619785953 |
|---|---|
| Provider Enumeration Date | 12/19/2024 |
| Last Update Date | 12/19/2024 |
| Certification Date | 12/19/2024 |
| Medicare PECOS PAC ID | 1052841889 |
|---|---|
| Medicare Enrollment ID | O20250210001684 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619785953 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Secondary |
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Provider Name | Casey Henshaw Ferguson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1518118918 PECOS PAC ID: 9931560349 Enrollment ID: I20240228000157 |
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